VETERANS AFFAIRS: Sweeping Pain Management Initiative
In a move likely to influence the medical community's approach to pain management, the Department of Veterans Affairs is set to launch a systemwide initiative to treat pain as a "fifth vital sign." The AP/Richmond Times-Dispatch reports that VA doctors and nurses will include a subjective rating of patients' pain -- on a scale of one to 10 -- in patient charts alongside blood pressure, pulse, temperature and breathing rate. "We're too often obsessed with the diagnosis and finding what's going on in a molecular, cellular, pharmacological level as opposed to, 'Is the person feeling better?'" said Dr. Kenneth Kizer, VA undersecretary for health. The initiative stems from agency efforts to "improve care for the dying," and allocates up to $5 million for staff training in the area of pain management. While the American Pain Society has "urged treatment of pain as a 'fifth vital sign' since 1995," many hospitals have been slow to tackle the issue, according to experts (Hughes, 2/1).
What a Relief
Calling the recent move "a significant step forward," APS Executive Director Richard Muir explained, "There are not many large organizations that have put together a systematic approach to pain management" ( AP/Baltimore Sun, 2/1). Dr. Thomas Reardon, president-elect of the American Medical Association, similarly applauded the VA initiative, saying, "There's a new awareness out there among the health care industry that we need to do a better job" treating pain. Addressing concerns over pain medication dependence, the VA's Kizer said, "The patient's going to die in two months from their cancer. What does it matter if they're addicted or not? Even though the science shows they don't become addicted."
Changing Our Ways
Kizer hopes the VA program, expected to take effect at all 1,100 VA facilities within three years, will prompt other health systems to alter their approach to pain management. "I looked at this as something that I hope would influence the practice of medicine throughout the country," he said, noting that many medical students will be exposed to the program through their training in VA facilities. AP/CNN reports that the issue might come to Congress' attention. In an effort to find "middle ground" in the assisted-suicide debate, Sen. Ron Wyden (D-OR) plans to "improve pain treatment through the Medicare and Medicaid insurance programs." He said, "It takes a while, but the federal government is finally starting to get it" (1/31).